Abstract
Small nodules, usually less than 10 mm in diameter, are regarded to be centrilobular when the nodules are separated from pleural surfaces or the interlobular septa by a distance of several millimeters, usually centered 4–10 mm from the pleural or fissural surfaces or from interlobular septa [1, 2]. They are frequently associated with centrilobular branching nodular structures, thus forming the so-called tree-in-bud sign (Figs. 18.1 and 18.2) (see also Chap. 9). The small nodules represent lesions involving the small airways. However, vascular lesions involving the arterioles and capillaries may simulate the centrilobular small nodules and branching nodular structures (vascular tree-in-bud sign) [1, 3, 4] (Fig. 18.3).
This is a preview of subscription content, log in via an institution.
Buying options
Tax calculation will be finalised at checkout
Purchases are for personal use only
Learn about institutional subscriptionsReferences
Lee KS, Kim TS, Han J, et al. Diffuse micronodular lung disease: HRCT and pathologic findings. J Comput Assist Tomogr. 1999;23:99–106.
Gruden JF, Webb WR, Naidich DP, McGuinness G. Multinodular disease: anatomic localization at thin-section CT–multireader evaluation of a simple algorithm. Radiology. 1999;210:711–20.
Han D, Lee KS, Franquet T, et al. Thrombotic and nonthrombotic pulmonary arterial embolism: spectrum of imaging findings. Radiographics. 2003;23:1521–39.
Chung MP, Yi CA, Lee HY, Han J, Lee KS. Imaging of pulmonary vasculitis. Radiology. 2010;255:322–41.
Hwang JH, Kim TS, Lee KS, et al. Bronchiolitis in adults: pathology and imaging. J Comput Assist Tomogr. 1997;21:913–9.
Lee KS, Kim YH, Kim WS, Hwang SH, Kim PN, Lee BH. Endobronchial tuberculosis: CT features. J Comput Assist Tomogr. 1991;15:424–8.
Im JG, Itoh H, Shim YS, et al. Pulmonary tuberculosis: CT findings–early active disease and sequential change with antituberculous therapy. Radiology. 1993;186:653–60.
Jeong YJ, Lee KS, Koh WJ, Han J, Kim TS, Kwon OJ. Nontuberculous mycobacterial pulmonary infection in immunocompetent patients: comparison of thin-section CT and histopathologic findings. Radiology. 2004;231:880–6.
Koh WJ, Lee KS, Kwon OJ, Jeong YJ, Kwak SH, Kim TS. Bilateral bronchiectasis and bronchiolitis at thin-section CT: diagnostic implications in nontuberculous mycobacterial pulmonary infection. Radiology. 2005;235:282–8.
Nishimura K, Kitaichi M, Izumi T, Itoh H. Diffuse panbronchiolitis: correlation of high-resolution CT and pathologic findings. Radiology. 1992;184:779–85.
Howling SJ, Hansell DM, Wells AU, Nicholson AG, Flint JD, Muller NL. Follicular bronchiolitis: thin-section CT and histologic findings. Radiology. 1999;212:637–42.
Bae YA, Lee KS, Han J, et al. Marginal zone B-cell lymphoma of bronchus-associated lymphoid tissue: imaging findings in 21 patients. Chest. 2008;133:433–40.
Bhalla M, Turcios N, Aponte V, et al. Cystic fibrosis: scoring system with thin-section CT. Radiology. 1991;179:783–8.
Moon JW, Lee HY, Han J, Lee KS. Tree-in-bud sign as a manifestation of localized pulmonary lymphatic metastasis from a pancreas cancer. Intern Med. 2011;50:3027–9.
Wagner JA, Nepomuceno IB, Shah N, et al. Maxillary sinusitis as a surrogate model for CF gene therapy clinical trials in patients with antrostomies. J Gene Med. 1999;1:13–21.
Miyano S, Izumi S, Takeda Y, et al. Pulmonary tumor thrombotic microangiopathy. J Clin Oncol. 2007;25:597–9.
Rollins S, Colby T, Clayton F. Open lung biopsy in Mycoplasma pneumoniae pneumonia. Arch Pathol Lab Med. 1986;110:34–41.
Reittner P, Muller NL, Heyneman L, et al. Mycoplasma pneumoniae pneumonia: radiographic and high-resolution CT features in 28 patients. AJR Am J Roentgenol. 2000;174:37–41.
Lee I, Kim TS, Yoon HK. Mycoplasma pneumoniae pneumonia: CT features in 16 patients. Eur Radiol. 2006;16:719–25.
Kim CK, Chung CY, Kim JS, Kim WS, Park Y, Koh YY. Late abnormal findings on high-resolution computed tomography after Mycoplasma pneumonia. Pediatrics. 2000;105:372–8.
Marrie TJ, Costain N, La Scola B, et al. The role of atypical pathogens in community-acquired pneumonia. Semin Respir Crit Care Med. 2012;33:244–56.
Song HJ, An JS, Han J, Koh WJ, Kim HK, Choi YS. Pathologic findings of surgically resected nontuberculous mycobacterial pulmonary infection. Korean J Pathol. 2010;44:56–62.
Kim TS, Koh WJ, Han J, et al. Hypothesis on the evolution of cavitary lesions in nontuberculous mycobacterial pulmonary infection: thin-section CT and histopathologic correlation. AJR Am J Roentgenol. 2005;184:1247–52.
Griffith DE, Aksamit TR. Bronchiectasis and nontuberculous mycobacterial disease. Clin Chest Med. 2012;33:283–95.
Koh WJ, Jeon K, Lee NY, et al. Clinical significance of differentiation of Mycobacterium massiliense from Mycobacterium abscessus. Am J Respir Crit Care Med. 2011;183:405–10.
Iwata M, Colby TV, Kitaichi M. Diffuse panbronchiolitis: diagnosis and distinction from various pulmonary diseases with centrilobular interstitial foam cell accumulations. Hum Pathol. 1994;25:357–63.
Kudoh S, Keicho N. Diffuse panbronchiolitis. Clin Chest Med. 2012;33:297–305.
Akira M, Kitatani F, Lee YS, et al. Diffuse panbronchiolitis: evaluation with high-resolution CT. Radiology. 1988;168:433–8.
Park HY, Suh GY, Chung MP, et al. Comparison of clinical and radiographic characteristics between nodular bronchiectatic form of nontuberculous mycobacterial lung disease and diffuse panbronchiolitis. J Korean Med Sci. 2009;24:427–32.
Kudoh S, Azuma A, Yamamoto M, Izumi T, Ando M. Improvement of survival in patients with diffuse panbronchiolitis treated with low-dose erythromycin. Am J Respir Crit Care Med. 1998;157:1829–32.
Yousem SA, Colby TV, Carrington CB. Follicular bronchitis/bronchiolitis. Hum Pathol. 1985;16:700–6.
Aerni MR, Vassallo R, Myers JL, Lindell RM, Ryu JH. Follicular bronchiolitis in surgical lung biopsies: clinical implications in 12 patients. Respir Med. 2008;102:307–12.
Sato Y, Marutsuka K, Asada Y, Yamada M, Setoguchi T, Sumiyoshi A. Pulmonary tumor thrombotic microangiopathy. Pathol Int. 1995;45:436–40.
Roberts KE, Hamele-Bena D, Saqi A, Stein CA, Cole RP. Pulmonary tumor embolism: a review of the literature. Am J Med. 2003;115:228–32.
Franquet T, Gimenez A, Prats R, Rodriguez-Arias JM, Rodriguez C. Thrombotic microangiopathy of pulmonary tumors: a vascular cause of tree-in-bud pattern on CT. AJR Am J Roentgenol. 2002;179:897–9.
Shepard JA, Moore EH, Templeton PA, McLoud TC. Pulmonary intravascular tumor emboli: dilated and beaded peripheral pulmonary arteries at CT. Radiology. 1993;187:797–801.
Bassiri AG, Haghighi B, Doyle RL, Berry GJ, Rizk NW. Pulmonary tumor embolism. Am J Respir Crit Care Med. 1997;155:2089–95.
Graham CM, Stern EJ, Finkbeiner WE, Webb WR. High-resolution CT appearance of diffuse alveolar septal amyloidosis. AJR Am J Roentgenol. 1992;158:265–7.
Johkoh T, Ikezoe J, Tomiyama N, et al. CT findings in lymphangitic carcinomatosis of the lung: correlation with histologic findings and pulmonary function tests. AJR Am J Roentgenol. 1992;158:1217–22.
Fujimura N. Pathology and pathophysiology of pneumoconiosis. Curr Opin Pulm Med. 2000;6:140–4.
Remy-Jardin M, Remy J, Farre I, Marquette CH. Computed tomographic evaluation of silicosis and coal workers’ pneumoconiosis. Radiol Clin North Am. 1992;30:1155–76.
Mitchell DN, Scadding JG, Heard BE, Hinson KF. Sarcoidosis: histopathological definition and clinical diagnosis. J Clin Pathol. 1977;30:395–408.
Baughman RP, Culver DA, Judson MA. A concise review of pulmonary sarcoidosis. Am J Respir Crit Care Med. 2011;183:573–81.
Brauner MW, Grenier P, Mompoint D, Lenoir S, de Cremoux H. Pulmonary sarcoidosis: evaluation with high-resolution CT. Radiology. 1989;172:467–71.
Criado E, Sanchez M, Ramirez J, et al. Pulmonary sarcoidosis: typical and atypical manifestations at high-resolution CT with pathologic correlation. Radiographics. 2010;30:1567–86.
Nishimura K, Itoh H, Kitaichi M, Nagai S, Izumi T. Pulmonary sarcoidosis: correlation of CT and histopathologic findings. Radiology. 1993;189:105–9.
Baughman RP, Drent M, Kavuru M, et al. Infliximab therapy in patients with chronic sarcoidosis and pulmonary involvement. Am J Respir Crit Care Med. 2006;174:795–802.
Bhargava P, Rushin JM, Rusnock EJ, et al. Pulmonary light chain deposition disease: report of five cases and review of the literature. Am J Surg Pathol. 2007;31:267–76.
Pickford HA, Swensen SJ, Utz JP. Thoracic cross-sectional imaging of amyloidosis. AJR Am J Roentgenol. 1997;168:351–5.
Chung MJ, Lee KS, Franquet T, Muller NL, Han J, Kwon OJ. Metabolic lung disease: imaging and histopathologic findings. Eur J Radiol. 2005;54:233–45.
Utz JP, Swensen SJ, Gertz MA. Pulmonary amyloidosis. The Mayo Clinic experience from 1980 to 1993. Ann Intern Med. 1996;124:407–13.
McGuinness G, Naidich DP, Jagirdar J, Leitman B, McCauley DI. High resolution CT findings in miliary lung disease. J Comput Assist Tomogr. 1992;16:384–90.
Voloudaki AE, Tritou IN, Magkanas EG, Chalkiadakis GE, Siafakas NM, Gourtsoyiannis NC. HRCT in miliary lung disease. Acta Radiol. 1999;40:451–6.
Choi D, Lee KS, Suh GY, et al. Pulmonary tuberculosis presenting as acute respiratory failure: radiologic findings. J Comput Assist Tomogr. 1999;23:107–13.
Ko KS, Lee KS, Kim Y, Kim SJ, Kwon OJ, Kim JS. Reversible cystic disease associated with pulmonary tuberculosis: radiologic findings. Radiology. 1997;204:165–9.
Laack E, Simon R, Regier M, et al. Miliary never-smoking adenocarcinoma of the lung: strong association with epidermal growth factor receptor exon 19 deletion. J Thorac Oncol. 2011;6:199–202.
Lalvani A. Diagnosing tuberculosis infection in the 21st century: new tools to tackle an old enemy. Chest. 2007;131:1898–906.
Sharma SK, Mohan A, Sharma A, Mitra DK. Miliary tuberculosis: new insights into an old disease. Lancet Infect Dis. 2005;5:415–30.
Hong SH, Im JG, Lee JS, Song JW, Lee HJ, Yeon KM. High resolution CT findings of miliary tuberculosis. J Comput Assist Tomogr. 1998;22:220–4.
Jeong YJ, Lee KS. Pulmonary tuberculosis: up-to-date imaging and management. AJR Am J Roentgenol. 2008;191:834–44.
Seo JB, Im JG, Goo JM, Chung MJ, Kim MY. Atypical pulmonary metastases: spectrum of radiologic findings. Radiographics. 2001;21:403–17.
Murata K, Takahashi M, Mori M, et al. Pulmonary metastatic nodules: CT-pathologic correlation. Radiology. 1992;182:331–5.
Hirakata K, Nakata H, Nakagawa T. CT of pulmonary metastases with pathological correlation. Semin Ultrasound CT MR. 1995;16:379–94.
Author information
Authors and Affiliations
Rights and permissions
Copyright information
© 2014 Springer-Verlag Berlin Heidelberg
About this chapter
Cite this chapter
Lee, K.S., Han, J., Chung, M.P., Jeong, Y.J. (2014). Small Nodules. In: Radiology Illustrated: Chest Radiology. Radiology Illustrated. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-37096-0_18
Download citation
DOI: https://doi.org/10.1007/978-3-642-37096-0_18
Published:
Publisher Name: Springer, Berlin, Heidelberg
Print ISBN: 978-3-642-37095-3
Online ISBN: 978-3-642-37096-0
eBook Packages: MedicineMedicine (R0)